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Objective: To investigate the association of nighttime awakenings at 12 months with the duration and efficiency of nighttime sleep at 6 years of age. Methods: Data from two population-based prospective studies (The Pelotas 2004 and The Pelotas 2015 Birth Cohorts) were used. Information on nighttime awakenings was provided by mothers during the 12-month follow-up interview. Infants who awakened >3 times after sleep onset at 12 months were considered frequent wakeners. Sleep duration and sleep efficiency were obtained by actigraphy at the 6-year follow-up. Children wore the device at the wrist of the non-dominant arm continuously for 3–7 days, including at least one weekend day. Unadjusted and adjusted beta coefficients were obtained by linear regression for each cohort separately. Results: 2500 children from the 2004 and 2793 from the 2015 cohort had full information on nighttime awakenings at 12 months and actigraphy at 6 years and were analyzed. Prevalence of frequent wakeners was 6.3 % and 5.9 % in the 2004 and 2015 cohort, respectively. Mean bedtime and wake-up time at 6 years were, respectively, 23:23 and 08:41 h in the 2004 cohort, and 00:10 and 09:00 h int the 2015 cohort. Nighttime sleep lasted on average 7.54 and 7.24 h respectively in the 2004 and the 2015 cohort, and the sleep efficiency was 81.1 and 82.5 % respectively. In adjusted analyses, no associations were found between awakening at 12 months and sleep duration or sleep efficiency at 6 years of age. Conclusion: In both cohorts sleep duration and efficiency were below the recommendation for school-age children (respectively 9–11 h and 85 %). There was no relationship between the number of nighttime awakenings at 12 months and sleep duration or efficiency at 6 years.

Abstract Background Physical activity in childhood is thought to influences health and development. Previous studies have found that boys are typically more active than girls, yet the focus has largely been on differences in average levels or proportions above a threshold rather than the full distribution of activity across all intensities. We thus examined differences in the distribution of physical activity between girls and boys in a multi-national sample of children. Methods We used the harmonised International Children Accelerometry Database (ICAD), including waist-worn accelerometry data from 15,461 individuals (Boys: 48.3%) from 9 countries. Employing Generalised Additive Models of Location, Shape, and Scale (GAMLSS) we investigated gender differences in the distribution of individuals, including comparisons of variability (SD) and average physical activity levels (mean and median) and skewness. We conducted this analysis for each activity intensity (Sedentary, Light, and Moderate-to-Vigorous (MVPA)) and a summary measure (counts per minute (CPM)). Results Sizable gender differences in the distribution of activity were found for moderate to vigorous activity and counts per minute, with boys having higher average levels (38% higher mean volumes of MVPA, 20% higher CPM), yet substantially more between-person variability (30% higher standard deviation (SD) for MVPA, 17% higher SD for CPM); boys’ distributions were less positively skewed than girls. Conversely, there was little to no difference between girls and boys in the distribution of sedentary or light-intensity activity. Conclusions Inequality in activity between girls and boys was driven by MVPA. The higher mean volumes of MVPA in boys occurred alongside greater variability. This suggests a need to consider the underlying distribution of activity in future research; for example, interventions which target gender inequality in MVPA may inadvertently lead to increased inequality within girls.

Abstract Introduction Infant and neonatal mortality estimates are typically derived from retrospective birth histories collected through surveys in countries with unreliable civil registration and vital statistics systems. Yet such data are subject to biases, including under-reporting of deaths and age misreporting, which impact mortality estimates. Prospective population-based cohort studies are an underutilized data source for mortality estimation that may offer strengths that avoid biases. Methods We conducted a secondary analysis of data from the Child Health Epidemiology Reference Group, including 11 population-based pregnancy or birth cohort studies, to evaluate the appropriateness of vital event data for mortality estimation. Analyses were descriptive, summarizing study designs, populations, protocols, and internal checks to assess their impact on data quality. We calculated infant and neonatal morality rates and compared patterns with Demographic and Health Survey (DHS) data. Results Studies yielded 71,760 pregnant women and 85,095 live births. Specific field protocols, especially pregnancy enrollment, limited exclusion criteria, and frequent follow-up visits after delivery, led to higher birth outcome ascertainment and fewer missing deaths. Most studies had low follow-up loss in pregnancy and the first month with little evidence of date heaping. Among studies in Asia and Latin America, neonatal mortality rates (NMR) were similar to DHS, while several studies in Sub-Saharan Africa had lower NMRs than DHS. Infant mortality varied by study and region between sources. Conclusions Prospective, population-based cohort studies following rigorous protocols can yield high-quality vital event data to improve characterization of detailed mortality patterns of infants in low- and middle-income countries, especially in the early neonatal period where mortality risk is highest and changes rapidly.

Abstract This study aimed to assess the mental health of a University community in South Brazil during the COVID-19 pandemic. A cross-sectional web-based survey was conducted between July-August 2020 through a self-administered questionnaire. All University staff and students were eligible. Depression was measured using the Patient Health Questionnaire-9 and anxiety by the Generalized Anxiety Disorder-7. To evaluate the effect of social distancing and mental health factors on outcomes, Poisson regression models with robust variance were performed, estimating Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI). 2,785 individuals participated in the study. Prevalence of depression and anxiety were 39.2% (95%CI 37.3-41.1) and 52.5% (95% CI 50.6-54.4), respectively. Undergraduate students showed a higher prevalence of the outcomes. Not leaving the house routinely, mental health care, and previous diagnosis of mental illness were associated with both outcomes. Those with a previous medical diagnosis of depression had a 58% (PR 1.58; 95%CI 1.44; 1.74) and anxiety a 72% (PR 1.72; 95%CI 1.56; 1.91) greater prevalence of depression than their peers. An alarming prevalence of psychopathologies was observed. Despite the well-known benefits of social distancing to public health, it requires a surveillance on the population’s mental health, especially students and those with previous mental illness diagnosis.

We assessed the associations of social distancing and mask use with symptomatic, laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in Porto Alegre, Brazil. We conducted a population-based case-control study during April–June 2020. Municipal authorities furnished case-patients, and controls were taken from representative household surveys. In adjusted logistic regression analyses of 271 case-patients and 1,396 controls, those reporting moderate to greatest adherence to social distancing had 59% (odds ratio [OR] 0.41, 95% CI 0.24–0.70) to 75% (OR 0.25, 95% CI 0.15–0.42) lower odds of infection. Lesser out-of-household exposure (vs. going out every day all day) reduced odds from 52% (OR 0.48, 95% CI 0.29–0.77) to 75% (OR 0.25, 95% CI 0.18–0.36). Mask use reduced odds of infection by 87% (OR 0.13, 95% CI 0.04–0.36). In conclusion, social distancing and mask use while outside the house provided major protection against symptomatic infection.

A pandemia de COVID-19 já causou mais de 399 milhões de infecções e custou a vida de mais de cinco milhões de pessoas no mundo, até 3 de março de 2022. Para reduzir a taxa de infecção, uma série de medidas de prevenção indicadas pela Organização Mundial da Saúde (OMS) foram adotadas pelos países, entre elas, o uso de máscara. O objetivo deste estudo é descrever a utilização de máscara na população brasileira, através da análise de dados do EPICOVID19-BR, um estudo de base populacional realizado em 133 cidades do país, em quatro fases entre março e agosto de 2020. A proporção de indivíduos que preferiram usar máscara quando saíam de casa foi de 97,9% (IC95%: 97,8-98,0). O entrevistador não visualizou a máscara do entrevistado em 50% (IC95%: 49,9-51,1) dos casos no momento da entrevista, no entanto, entre a fase uma e quatro da pesquisa, observou-se uma diminuição de 4,4 pontos percentuais na proporção de entrevistados que não usaram máscara no momento da entrevista. A não visualização da máscara foi mais observada em mulheres, participantes com idade entre 10-19 e 20-29 anos, de cor de pele indígena, preta, e parda, entre as pessoas com Ensinos Fundamental e Médio e na Região Centro-oeste. O uso de máscara de tecido foi predominante 91,4% (IC95%: 91,2-91,5) com um aumento de 4,9 pontos percentuais entre as fases 1 e 4. Os resultados do estudo trazem informações importantes para reforçar as políticas de controle de COVID-19 no Brasil. O alto percentual de pessoas sem máscara na hora da entrevista sugere que ainda é importante reforçar o aspecto preventivo e de autocuidado, não fazendo do uso da máscara algo apenas ligado à obrigatoriedade.

Abstract Since the beginning of the pandemic of COVID-19, there has been a widespread assumption that most infected persons are asymptomatic. Using data from the recent wave of the EPICOVID19 study, a nationwide household-based survey including 133 cities from all states of Brazil, we estimated the proportion of people with and without antibodies for SARS-CoV-2 who were asymptomatic, which symptoms were most frequently reported, number of symptoms and the association with socio-demographic characteristics. We tested 33,205 subjects using a rapid antibody test previously validated. Information was collected before participants received the test result. Out of 849 (2.7%) participants positive for SARS-CoV-2 antibodies, only 12.1% (95% CI 10.1–14.5) reported no symptoms, compared to 42.2% (95% CI 41.7–42.8) among those negative. The largest difference between the two groups was observed for changes in smell/taste (56.5% versus 9.1%, a 6.2-fold difference). Changes in smell/taste, fever and body aches were most likely to predict positive tests as suggested by recursive partitioning tree analysis. Among individuals without any of these three symptoms, only 0.8% tested positive, compared to 18.3% of those with both fever and changes in smell or taste. Most subjects with antibodies against SARS-CoV-2 are symptomatic, even though most present only mild symptoms.

We aimed to assess the proportion of the population in 133 Brazilian municipalities who - from March to August 2020 - had a health problem but failed to seek care or failed to attend to a health service for routine appointment or examination. We conducted a household survey from August 24-27 in 133 Brazilian cities by asking the subjects if, since the beginning of the COVID-19 pandemic in March 2020, they had suffered from a health problem but did not seek care or failed to attend to a routine or screening examination. Poisson regression was used for the analyses. We interviewed 33,250 subjects and 11.8% (95%CI: 11.4-12.1) reported that, since March 2020, they failed to seek care despite being ill, 17.3% (95%CI: 16.9-17.7) failed to attend to a routine or screening examination and 23.9% (95%CI: 23.4-24.4) reported one or both outcomes. Health service closure and fear of the COVID-19 infection were the main reasons for not seeking care. Women and the poorest were more likely to not look for a health service, despite having a health problem or a scheduled routine appointment. On the other hand, those subjects who self-identified as white were less likely to not look for a health service. The COVID-19 pandemic is more critical for the indigenous people and the poorest, and these people are also more likely to not seek care for other health conditions during the pandemic.

Abstract Purpose The Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. Methods Data were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. Results/findings Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. Conclusions Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.

Abstract Background The work of The Global Observatory for Physical Activity-GoPA! is the first global effort to compile standardized country-level surveillance, policy and research data for physical activity in order to better understand how countries and regions address promoting physical activity. GoPA! developed standardized country-specific physical activity profiles (“Country Cards”) to summarize country-level data through 2013. The aim of this study was to assess use of the Country Cards, identify the factors associated with their use, and develop recommendations for supporting country-level physical activity promotion. Methods Cross sectional internet-based survey conducted between August–October 2016. Target study participants were national physical activity leaders and advocates in academia, government and practice from the GoPA! countries, and members of the International Society of Physical Activity and Health. A Country Card use composite score was created based on the diversity and frequency of use. Statistical analyses on the associations between the composite score and respondent characteristics, country characteristics, barriers and opinions were conducted (including descriptive analyses and a logistic regression with robust standard errors). Results One hundred forty three participants from 68 countries completed the survey. Use of the Country Cards was associated with being part of the GoPA! network, knowing about the Country Cards, and on the stage of country capacity for physical activity promotion. Country Card knowledge varied by country income group, region and the country specific context. More diverse and frequent use of the cards (highest tertile of the composite score for use) was associated with: 1. Being a country contact vs general participant (OR 18.32–95% CI 5.63–59.55, p = 0.002), and 2. Collaborating with a government representative working in NCDs on a monthly or more frequent contact vs less frequent contact (OR 3.39–95% CI 1.00–11.54, P

Abstract Background Substantial evidence suggests that weight gain in early life is associated with increased adiposity and other metabolic disorders later in life. It is, however, unknown whether physical activity (PA) may modify these associations. We aimed to examine whether objectively measured PA at 30 years modified the associations between conditional weight gain in infancy (0–2 y) and childhood (2–4 y) with fat mass index (FMI) and visceral abdominal fat measured at age 30 years. Methods Prospective birth cohort study in Pelotas, Brazil, including 1874 participants with weight data at birth, two and four years of age, and measures of FMI, visceral abdominal fat and PA at a mean age of 30.2 years. At age 30, time spent (min/day) in moderate-to-vigorous physical activity (MVPA) was measured objectively using a wrist-worn accelerometer worn for four to seven consecutive days.. Multiple linear regression analyses was performed to assess the associations between conditional weight gain and outcome variables at 30 years, adjusting for covariates. We examined whether PA modified the association between conditional weight gain and the outcomes of interest by introducing an interaction term (conditional weight gain × PA) in the models. Results Conditional weight gain in infancy and childhood were both positively associated with later FMI (infancy weight gain: β = 0.68, 95% CI: 0.48, 0.88; P

Physical activity declines during youth but most evidence reports on combined moderate and vigorous-intensity physical activity. We investigated how vigorous-intensity activity varies with age.Cross-sectional data from 24,025 participants (5.0–18.0 y; from 20 studies in 10 countries obtained 2008–2010) providing ≥1 day accelerometer data (International Children's Accelerometry Database (ICAD)). Linear regression was used to investigate age-related patterns in vigorous-intensity activity; models included age (exposure), adjustments for monitor wear-time and study. Moderate-intensity activity was examined for comparison. Interactions were used to investigate whether the age/vigorous-activity association differed by sex, weight status, ethnicity, maternal education and region.A 6.9% (95% CI 6.2, 7.5) relative reduction in mean vigorous-intensity activity with every year of age was observed; for moderate activity the relative reduction was 6.0% (5.6%, 6.4%). The age-related decrease in vigorous-intensity activity remained after adjustment for moderate activity. A larger age-related decrease in vigorous activity was observed for girls (−10.7%) versus boys (−2.9%), non-white (−12.9% to −9.4%) versus white individuals (−6.1%), lowest maternal education (high school (−2.0%)) versus college/university (ns) and for overweight/obese (−6.1%) versus healthy-weight participants (−8.1%). In addition to larger annual decreases in vigorous-intensity activity, overweight/obese individuals, girls and North Americans had comparatively lower average vigorous-intensity activity at 5.0–5.9 y.Age-related declines in vigorous-intensity activity during youth appear relatively greater than those of moderate activity. However, due to a higher baseline, absolute moderate-intensity activity decreases more than vigorous. Overweight/obese individuals, girls, and North Americans appear especially in need of vigorous-intensity activity promotion due to low levels at 5.0–5.9 y and larger negative annual differences. Keywords: ICAD, Motor activity, Child, Adolescent, Epidemiology

Abstract Background This study was conducted to examine the lifestyle behaviors and health promoting practices of physicians, nurses, and community health workers in Brazil. Methods A random sample of primary health care units in Brazil was selected, and a pretested questionnaire was administered via phone interviews, in 2011, to 182 physicians, 347 nurses, and 269 community health workers, totaling 798 health professionals. The total initial sample included 1600 eligible health professionals. Variables measured included physical activity, alcohol intake, hours of sleep, diet, and perceived self-efficacy to provide preventive counseling on related lifestyle behaviors. Results More than 25 % of physicians, nurses, and community health workers reported eating 0–2 portions of fruits and vegetables per day. In terms of cervical and breast cancer, nurses reported to be ‘very prepared’ to advise patients on these topics more frequently than physicians. The prevalence of smoking ranged from 4.9 % among nurses to 7.4 % among community health workers. The proportion of physical inactivity ranged from 40.3 % among nurses to 52.1 % among community health workers. Conclusion A reasonably high proportion of physicians, nurses, and community health workers report not engaging in healthy lifestyle behaviors that impact chronic diseases, thus, they may be less likely to encourage such behaviors in their patients.

Objectives: To measure knowledge of current recommendations of physical activity and consequences of physical inactivity among healthcare providers throughout Brazil. Methods: A phone survey of 1600 randomly selected primary healthcare units in Brazil was conducted between January and July 2011. At each unit, a physician, nurse or community healthcare worker (n = 798) responded to a 40-minute survey, eliciting information about demographics, knowledge, and health behaviors pertaining to physical activity. Results: Among nurses and community healthcare workers, >95% reported needing more information on physical activity guidelines. Among physicians this proportion was 80%. Nearly 40% of the professionals incorrectly believed 90-min of moderate-intensity physical activity per week is the recommended amount for health benefits; nearly 30% believed that 90-min of vigorous-intensity activity per week is needed for the same purpose. More than 75% of all groups reported that type II diabetes, hypertension, depression, and coronary heart disease might result from physical inactivity, but on average only 60% from each group are aware of osteoporosis as a possible consequence of physical inactivity. Conclusions: Training health professionals in how to convey all relevant information about physical activity to their patients is critical for health promotion within the primary care system in Brazil.

The aim of this study was to describe the characteristics of programs that promote physical activity in the public primary care system by region of Brazil, subject to the presence or absence of multidisciplinary primary care teams (NASF). We conducted a cross sectional and population-based telephone survey of the health unit coordinators from 1,251 health care units. Coordinators were asked about the presence and characteristics of physical activity programs. Four out of ten health units reported having a physical activity intervention program, the most common involving walking groups. Most of the activities were performed in the morning, once or twice a week, and in sessions of 30 minutes or more. Physical education professionals were primarily responsible for directing the activities. Interventions occurred in the health unit itself or in adjacent community spaces. In general, these characteristics were similar between units with or without NASF, but varied substantially across regions. These findings will guide future physical activity policies and programs within primary care in Brazil.

Objetivou-se avaliar a associação entre comportamentos de risco à saúde dos pais e adolescentes escolares de zona rural. Participaram 377 escolares entre 10 e 18 anos e 338 pais. Foram analisados: nível de atividade física no lazer e deslocamento, hábitos de alimentação inadequados, excesso de peso, uso de cigarros e consumo de bebidas alcoólicas. A prevalência de relato de uso de cigarro e álcool nos últimos 30 dias entre os jovens foi de 6,7% e 27%, respectivamente. Quarenta e cinco por cento dos adolescentes não atingiram o escore de atividade física. A adesão aos passos para uma alimentação saudável foi baixa. A atividade física dos adolescentes esteve relacionada de forma positiva com a dos pais, e o consumo de álcool da mãe se associou de forma positiva com o consumo do adolescente. Para os outros comportamentos, não houve associação significativa. Na análise estratificada por sexo, o nível de atividade física do pai se associou ao nível de atividade física das meninas. O comportamento de risco à saúde dos pais associa-se ao mesmo comportamento dos adolescentes de zona rural.This article aimed to assess the association between health risk behaviors in parents and adolescents in a rural area. The sample included 377 schoolchildren 10 to 18 years of age and 338 parents. The following variables were analyzed: level of leisure-time and commuting physical activity, inadequate eating habits, overweight/obesity, smoking, and alcohol consumption. Prevalence rates for smoking and alcohol consumption by adolescents in the previous 30 days were 6.7% and 27%, respectively. Forty-five percent of adolescents failed to reach the target physical activity score. Adherence to steps to healthy eating was low. Physical activity in adolescents was positively associated with that of parents, and adolescent drinking was associated with maternal alcohol consumption. There was no significant association for other behaviors. In the analysis stratified by gender, level of physical exercise in female adolescents was associated with that of fathers. Parental health risk behaviors were associated with the behaviors in the adolescent children in this rural area.

O objetivo foi avaliar a associação entre tamanho ao nascer e problemas de saúde mental aos 11 anos na Coorte de Nascimentos de Pelotas, Rio Grande do Sul, Brasil, de 1993. Foram pesados e medidos ao nascer 4.358 recém-nascidos. Avaliou-se problemas de saúde mental com o questionário de capacidades e dificuldades (Strengths and Difficulties Questionnaire - SDQ). A prevalência de problemas de saúde mental foi de 32% (IC95%: 31-33). Na análise ajustada, os 291 (6,7%) recém-nascidos com escorez de peso/idade e os 268 (6,2%) com índice de massa corporal (IMC)/idade < -2 DP tiveram, respectivamente, 27% (IC95%: 7-49) e 29% (IC95%: 10-51) maior risco de apresentar problemas de saúde mental aos 11 anos quando comparados com aqueles com escore normal. Os 102 (2,43%) recém-nascidos com escorez de IMC e os 279 (6,4%) com perímetro cefálico/idade > +2 DP tiveram, respectivamente, 34% (IC95%: 6-71) e 19% (IC95%: 1-40) maior risco de apresentar esses problemas se comparados com aqueles com escore normal. Os resultados sugerem que fatores ocorridos na gestação e refletidos nas medidas de tamanho ao nascer podem ocasionar problemas de saúde mental em etapas tardias.

The study aims to describe and compare two methods of energy intake assessment and one measure of energy expenditure applied in adolescents from a birth cohort. In a sub-sample of the 1993 Pelotas (Brazil) birth cohort, followed up in 2006-7, information on intake was obtained through a food-frequency questionnaire (FFQ) and three 24-hour-recalls (24hR), while energy expenditure was assessed using an accelerometer. Bland & Altman plots were used in the analyses in order to compare the methods. The mean difference between FFQ and 24hR was 592 ± 929cal/day. Compared to energy expenditure, intake was overestimated when measured by FFQ (357 ± 968cal/day) and underestimated by 24hR (-278 ± 714cal/day). In spite of the great differences between energy intake obtained using the two methods, lower differences were observed when these methods were compared to expenditure.O objetivo do estudo foi descrever e comparar dois métodos de avaliação de consumo calórico e uma medida de gasto energético aplicados em adolescentes de uma coorte de nascimentos. Em uma subamostra da coorte de 1993 de Pelotas, Rio Grande do Sul, Brasil, acompanhada em 2006-2007, informações sobre consumo calórico foram obtidas através de questionário de frequência alimentar (QFA) e três recordatórios de 24 horas (R24h), enquanto gasto energético foi avaliado por acelerômetro. Gráficos de Bland & Altman foram usados na comparação dos métodos. A diferença média entre QFA e R24h foi 592 ± 929cal/dia. Ao comparar com gasto energético, o consumo foi superestimado se medido pelo QFA (357 ± 968cal/dia) e subestimado pelo R24h (-278 ± 714cal/dia). Apesar da grande diferença no consumo, menores diferenças foram observadas quando os dois métodos foram comparados ao gasto energético.

The aim of this study was to investigate medicine use and associated factors among adolescents. This was a prospective cohort study including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. Information on medicine use in the 15 days prior to the interviews was collected from the mothers. Overall prevalence of medicine use was 30.9%, and 64.7% of the medicines had been prescribed by a physician. The most frequently used pharmacological groups were medicines for the nervous (35.9%) and respiratory systems (25.7%). Medicine use was directly associated with socioeconomic status, maternal schooling, complications during pregnancy or delivery, and neonatal problems resulting in the need for intensive care. Underweight and obese adolescents were more likely to use medicines as compared to those with normal body mass index. A direct association was observed between maternal use of hypnotic drugs and sedatives and adolescent medicine use. It is essential to implement educational policies aimed at promoting rational use of medicines by adolescents.O objetivo deste estudo foi investigar o uso de medicamentos e fatores associados em adolescentes. Trata-se de estudo de coorte prospectivo, incluindo 4.452 adolescentes nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1993. As informações sobre o uso de medicamentos pelo adolescente nos 15 dias anteriores à entrevista foram fornecidas pelas mães. A prevalência global de uso de medicamentos foi de 30,9%, sendo que destes, 64,7% foram indicados por médicos. Os grupos farmacológicos mais utilizados foram os medicamentos que atuam nos sistemas nervoso (35,9%) e respiratório (25,7%). O uso de medicamentos esteve diretamente associado ao nível econômico, escolaridade da mãe, intercorrência na gravidez ou parto que gerou doença até a adolescência, problema de saúde no momento do nascimento que levou o recém-nascido à UTI, magreza e obesidade. Foi observada uma relação direta entre uso de medicamentos hipnóticos e sedativos pela mãe e uso de medicamentos pelo adolescente. É fundamental que medidas educativas sejam voltadas à promoção do uso racional de medicamentos nesta faixa etária.

Evidence has shown the negative effects of unsupervised diets and those with excessive calorie restriction. The aim of this study was to determine the proportion of adolescents engaging in weight loss dieting and associated factors. This was a cross-sectional study of 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. The outcome was defined as adolescents that reported having practiced some type of weight loss dieting in the previous 12 months. Prevalence of such dieting was 8.6% (95%CI: 7.7;9.4), and was higher in girls. Elevated maternal body mass index (BMI) was associated with dieting among girls. The adolescent's and parents' view of the adolescent's weight, excess weight, and consumption of diet or light soft drinks were associated with adolescent dieting. There was a positive association between dieting and socioeconomic status. The findings provide important backing for policies aimed at improving adolescents' diet, since they express a major concern over weight and thus a significant percentage of individuals with erroneous and unhealthy behaviors.Evidências mostram efeitos negativos de dietas sem orientação e de alta restrição calórica. O objetivo do estudo foi determinar o percentual de adolescentes que realizaram regime de emagrecimento e os fatores associados a este comportamento. Estudo transversal incluindo 4.452 nascidos em Pelotas, Rio Grande do Sul, Brasil, no ano de 1993. Os adolescentes que relataram ter feito algum tipo de regime com a finalidade de emagrecimento nos últimos 12 meses foram positivos ao desfecho. A freqüência de realização de regime foi de 8,6% (IC95%: 7,7;9,4), sendo maior entre as meninas. O índice de massa corporal (IMC) materno elevado associou-se à realização de regime entre meninas. O sentimento do adolescente e dos pais em relação ao peso do jovem, o excesso de peso e o consumo de refrigerantes diet/light mostraram-se associados ao desfecho. Encontrou-se associação positiva entre regime e nível econômico. Tais achados constituem-se um importante subsídio para formação de políticas a fim de melhorar a dieta de adolescentes, uma vez que expressa a grande preocupação com o peso, e assim, um porcentual significativo de indivíduos tendo comportamentos equivocados.

We evaluate the influence of demographic, socioeconomic, and maternal variables on the nutritional status of adolescents aged 11 years. We conducted a prospective cohort study including 4,452 adolescents born in Pelotas, Southern Brazil, in 1993, accounting for 87.5% of the original cohort. Nutritional status was evaluated based on World Health Organization criteria. Subjects were classified according to nutritional status into thin, normal, overweight and obese. Independent variables analyzed included skin color, socioeconomic status, maternal schooling, and maternal body mass index (BMI). Analyses were stratified by sex, and multivariable regression was performed using the multinomial logistic approach. Overall, 7% of adolescents were classified as thin, 11.6% as overweight, and 11.6% as obese. Among boys, thinness was inversely associated with maternal schooling and maternal BMI. Among girls, thinness was directly associated with maternal BMI. Overweight and obesity were directly associated with socioeconomic status and maternal BMI, the former showing the strongest association with nutritional status among adolescents.O objetivo deste estudo foi avaliar a influência de fatores demográficos, sócioeconômicos e maternos sobre o estado nutricional de adolescentes, nascidos em 1993, em Pelotas, Rio Grande do Sul, Brasil. A amostra estudada (n = 4.452) representa 87,5% da coorte original. O estado nutricional foi avaliado conforme as recomendações da Organização Mundial da Saúde, categorizado em magro, eutrófico, sobrepeso e obeso. As variáveis independentes foram cor da pele, índice de bens, escolaridade e índice de massa corporal (IMC) maternos. As análises foram estratificadas por sexo, e a regressão logística multinomial foi usada. Ao todo, 7% dos adolescentes eram magros, 11,6% tinham sobrepeso e 11,6% eram obesos. Entre os meninos, a prevalência de adolescentes magros apresentou associação inversa com escolaridade e IMC maternos. Entre as meninas, ser magra se associou inversamente com o IMC materno. Sobrepeso e obesidade mostraram-se associados diretamente com índice de bens e IMC maternos, sendo esta última, a principal variável associada com o estado nutricional dos adolescentes.

The aim of this study was to estimate the prevalence of experimental alcohol intake and associated factors in early adolescence. The overall sample consisted of 4,452 adolescents (mean age = 11.3 years; SD = 0.3) from the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Experimental use of alcohol was reported by 17.5% of the interviewees (95%CI: 16.3-18.6), and 5% reported having tried alcohol at nine years of age or younger. Prevalence of experimental alcohol use was higher among adolescents whose mothers had consumed alcohol during pregnancy, whose parents consumed alcohol, who worked outside the home themselves, and who had ever tried smoking. Family strife, parental alcohol intake, and adolescent smoking were strong predictors of experimental alcohol use in early adolescence. Special attention should be targeted to these groups in order to avoid heavy and premature alcohol use in early adolescence.Este trabalho teve como objetivo avaliar a prevalência de uso experimental de bebidas alcoólicas e fatores associados no início da adolescência. Compuseram a amostra 4.452 adolescentes (média = 11,3 anos; DP = 0,3) da coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil. O uso experimental de álcool foi referido por 17,5% dos entrevistados (IC95%: 16,3-18,6) e 5% referiram ter experimentado com nove anos ou menos. O risco de uso experimental de álcool foi maior nos adolescentes cujas mães referiram ter bebido na gestação, quando ambos os pais usavam bebidas alcoólicas, entre os adolescentes que trabalhavam fora e naqueles que já experimentaram cigarro ou outras drogas. As relações familiares, o uso de álcool pelos pais, e o tabagismo do adolescente são os fatores fortemente associados ao uso experimental de álcool no início da adolescência. Mais atenção deveria ser dada especialmente a esses grupos, a fim de combater o consumo precoce de álcool.

Studies on well-being and its possible determinants are rare in the international literature, and almost non-existent in Brazil, particularly among youth. The present study focused on the epidemiology of well-being among adolescents belonging to a birth cohort. Well-being was measured using face-to-face interviews, with a question whose answer was based on a graphic scale of faces. 4,452 adolescents were interviewed. Approximately half (49.4%) classified themselves as very happy (face 1); this proportion was higher among girls than boys. Poorer adolescents were more likely than their wealthier peers to identify with the happiest face (number 1), but were also more likely to report moderate to low levels of well-being (faces 3-7). Body mass index was inversely associated with well-being. Among girls, physical activity was directly associated with well-being.Estudos sobre os níveis de bem-estar e seus possíveis determinantes são escassos na literatura mundial e quase inexistentes no Brasil, principalmente entre jovens. O objetivo do presente estudo foi conhecer a epidemiologia do bem-estar em adolescentes pertencentes a uma coorte de nascimentos. O nível de bem-estar foi coletado mediante entrevistas domiciliares, utilizando uma pergunta, cuja resposta era baseada em uma escala gráfica de faces. Foram entrevistados 4.452 adolescentes. Aproximadamente a metade (49,4%) identificou-se com a face 1 (muito felizes), sendo esta proporção maior nas meninas do que nos meninos. Os adolescentes mais pobres apresentaram maior prevalência de nível muito elevado de bem-estar (face 1) do que os mais ricos, mas também foram os que apresentaram maior prevalência de bem-estar moderado ou baixo (faces 3 a 7). Quanto maior a categoria de índice de massa corporal menor a proporção de jovens com elevado bem-estar (face 1). As meninas fisicamente ativas apresentaram maior percentual de elevado bem-estar em comparação às sedentárias.

The aim of this prospective analysis was to describe the cumulative incidence of hospital admissions in the first year of life and between 1 and 11 years of age and to explore associated factors. Hospital admissions were collected through regular monitoring in the first year of life, and through maternal report on admissions between 1 and 11 years. Analyses were stratified by sex and adjusted for confounding factors. 18.1% of children were hospitalized in the first year of life, and 30.7% between ages 1 and 11 years. Among boys, hospital admission in the first year was associated with low family income, paternal smoking during pregnancy, preterm delivery, and low birthweight. Among girls, in addition to the variables described for boys, black/mixed skin color was also a risk factor for hospital admission. For admissions between 1 and 11 years of age, low family income and gestational age > 37 weeks were found to be significant risk factors.Com o objetivo de descrever a incidência cumulativa de hospitalizações no primeiro ano de vida e entre 1-11 anos de idade, e identificar fatores de risco precoces, foi realizado um estudo de coorte de nascimento de 1993 a 2004-2005. As hospitalizações foram coletadas por meio de monitoramento hospitalar até 1 ano de idade, e relato das mães sobre internações ocorridas de 1-11 anos. As análises foram estratificadas por sexo e ajustadas para fatores de confusão. Os percentuais de hospitalizações de 0-1 ano e de 1-11 anos foram 18,1% e 30,7%, respectivamente. As variáveis associadas com internações de 0-1 ano em meninos foram: baixa renda familiar, tabagismo paterno na gestação, prematuridade e baixo peso ao nascer. No sexo feminino, além dos fatores de risco descritos entre os meninos, observou-se associação com cor da pele preta/parda. Quanto às hospitalizações de 1-11 anos, no sexo masculino, encontrou-se associação com baixa renda familiar e idade gestacional > 37 semanas.

The aim of this study was to evaluate concurrent risk factors for high blood pressure in adolescents. This is a prospective cohort study including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. Blood pressure was measured before and after the interview, and the mean value was used in the analyses. Mean systolic blood pressure was 101.9mmHg (SD = 12.3) and mean diastolic pressure was 63.4mmHg (SD = 9.9). Adolescents with black skin had higher blood pressure than those with white skin. Mean systolic pressure among subjects in the top quartile of body mass index (BMI) was 11.6mmHg higher than among those in the lowest quartile. Mean systolic pressure among postmenarcheal girls was 5.4mmHg higher than among premenarcheal girls. Similar trends were found for diastolic arterial pressure. Our findings suggest that blood pressure control must begin already in childhood and adolescence.O objetivo do presente artigo foi avaliar fatores associados com a pressão arterial de adolescentes. Trata-se de estudo de coorte prospectivo, incluindo 4.452 adolescentes nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1993. A pressão arterial foi medida no início e final da entrevista com aparelho digital, sendo o valor médio utilizado nas análises. A pressão arterial sistólica média foi de 101,9mmHg (DP = 12,3) e a diastólica foi de 63,4mmHg (DP = 9,9). Adolescentes com pele preta apresentaram valores mais elevados de pressão arterial sistólica do que os de pele branca. Adolescentes no quartil superior do índice de massa corporal (IMC) apresentaram uma pressão sistólica média 11,6mmHg maior do que aqueles no quartil inferior. Meninas que já menstruaram apresentaram uma pressão sistólica média 5,4mmHg maior em comparação às demais. Os resultados foram similares para a pressão arterial diastólica. O controle da pressão arterial elevada deve ser iniciado desde a infância e adolescência.

The aim of this study was to verify the agreement between different approaches for estimating levels of physical activity in adolescents. One questionnaire was administered to parents and two were administered to the adolescents. This was a cross-sectional analysis of data collected in the 2004-2005 follow-up of the 1993 Pelotas (Brazil) birth cohort study. Parents or guardians answered the following question: "Compared to most children the same age, would you say that your child exercises more, less, or the same amount?" A similar question was addressed to adolescents, as was a detailed questionnaire on physical activity. Agreement between the questionnaires was measured by the weighted kappa statistic. A total of 4,254 adolescents and parents/guardians answered the questionnaires. Kappa values indicated low agreement for all comparisons (kappa < 0.33 for all analyses). Measurement of physical activity in adolescents is complex, and available instruments should be validated prior to their use.O objetivo deste estudo foi verificar a concordância entre diferentes formas de se estimar o nível de atividade física de adolescentes. Um questionário foi aplicado aos pais e outros dois aos adolescentes. O estudo foi transversal aninhado ao acompanhamento de 2004-2005 da coorte de nascimentos de 1993 em Pelotas, Rio Grande do Sul, Brasil. Pais ou responsáveis responderam à questão: "Comparando com a maioria das crianças da mesma idade, o(a) Sr(a). diria que o seu filho faz mais exercícios que elas, menos exercícios que elas ou a mesma quantidade que elas?". Questão análoga foi aplicada aos adolescentes. Os adolescentes também responderam a um questionário mais detalhado sobre a prática de atividades físicas. A concordância entre os questionários foi avaliada pelo teste kappa ponderado. Um total de 4.254 adolescentes e responsáveis responderam aos questionários. Os valores de kappa indicaram concordância baixa para quaisquer das comparações (kappa < 0,33 para todas as análises). A mensuração de atividade física em adolescentes é complexa e os instrumentos disponíveis devem ser validados antes do uso.

The aim of this study was to describe resting pulse rate and associated factors among adolescents. This was a cross-sectional analysis nested in a prospective cohort study, including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil in 1993, representing 87.5% of the original cohort. Pulse rate was measured with an electronic device at the beginning and end of the interview, and the mean value was used in the analyses. Mean pulse rate was 78.4bpm (SD = 11.0) in the total sample, 76.5bpm (SD = 10.7) in boys, and 80.2bpm (SD = 10.9; p < 0.001) in girls. Black adolescents showed lower mean pulse rates. There was a direct association between pulse rate and blood pressure. Physical activity was inversely associated with pulse rate in the crude analysis only. Elevated pulse rate is strongly associated with high blood pressure, and both variables are predictors of risk of chronic disease in adulthood.O objetivo do estudo foi descrever a freqüência do pulso de repouso em adolescentes e avaliar variáveis associadas. Trata-se de análise transversal aninhada a um estudo de coorte prospectivo, incluindo 4.452 adolescentes nascidos em Pelotas, Rio Grande do Sul, Brasil, em 1993, os quais representam 87,5% da coorte original. A freqüência do pulso foi mensurada no início e ao final da entrevista com aparelho digital, sendo o valor médio utilizado nas análises. O valor médio da freqüência do pulso foi de 78,4bpm (DP = 11,0), sendo de 76,5bpm (DP = 10,7) nos meninos e 80,2bpm (DP = 10,9; p < 0,001) nas meninas. Os adolescentes com pele preta apresentaram valores mais baixos da freqüência do pulso. Houve uma forte associação positiva entre pressão arterial e freqüência do pulso. O escore de atividade física associou-se inversamente com a freqüência do pulso somente na análise bruta. Valores elevados de freqüência do pulso estão fortemente relacionados com valores elevados de pressão arterial, sendo ambas variáveis preditoras do risco de doenças crônicas na vida adulta.

The aim of this study was to assess early determinants of attention and hyperactivity problems in adolescents. In 1993, all hospital births in the city of Pelotas, Rio Grande do Sul State, Brazil, were monitored and mothers were interviewed (N = 5,249). At 11 years of age, 4,423 mothers answered the Strengths and Difficulties Questionnaire (SDQ) in order to evaluate attention and hyperactivity problems in the adolescents. Crude and adjusted prevalence ratios were calculated using Poisson regression. Prevalence of attention and hyperactivity problems was 19.9%. Factors associated with the outcome in the adjusted analysis were: male gender, low family income, smoking during pregnancy, minor psychiatric disorders in the mother, and history of child's behavioral/emotional problems at four years of age. Early life events impacted attention and hyperactivity problems in adolescence. Risk factors for attention and hyperactivity problems found in this study were similar to those reported in other cultures.O objetivo deste trabalho foi estudar determinantes precoces dos problemas de atenção e hiperatividade em adolescentes. Em 1993, os nascimentos foram recrutados e as mães entrevistadas (n = 5.249). Aos 11 anos, 4.423 mães responderam ao Strengths and Difficulties Questionnaire (SDQ) para avaliar problemas de atenção e hiperatividade nos adolescentes. Variáveis socioeconômicas, demográficas, biológicas e psicológicas foram investigadas como prováveis fatores de risco. Razões de prevalência brutas e ajustadas foram calculadas com regressão de Poisson. A prevalência de problemas de atenção e hiperatividade foi 19,9%. Sexo masculino, baixa renda familiar, tabagismo materno na gestação, transtornos psiquiátricos maternos e problemas de comportamento/emocionais do adolescente aos quatro anos permaneceram associados na análise ajustada. Eventos do início da vida influenciaram os problemas de atenção e hiperatividade na adolescência. Os fatores de risco para problemas de atenção e hiperatividade foram similares aos encontrados em diferentes culturas.

This study describes the food intake of adolescents participating in the 1993 birth cohort from Pelotas, Southern Brazil, according to socioeconomic position. We carried out a cross-sectional analysis of data collected in the 2004-2005 follow-up visit. Food intake in the previous year was evaluated using the Block questionnaire. Socioeconomic status was evaluated based on an assets index, divided into quintiles. Foods with the highest frequency of daily intake were white bread (83%), butter or margarine (74.6%), beans (66.4%) and milk (48.5%). Intake of butter or margarine, bread, and beans was more frequent among poorer adolescents, and the inverse was true for milk. Intake of fruits and vegetables was low in all socioeconomic strata, but particularly low among the poor. In early adolescence, all socioeconomic groups showed high consumption of foods rich in fat and low consumption of foods rich in fiber.O estudo descreve alimentos consumidos por adolescentes pertencentes à coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil, conforme o nível socioeconômico. Foi feita uma análise transversal com dados coletados no acompanhamento de 2004-2005. A freqüência alimentar no último ano foi avaliada pelo questionário Block. A posição socioeconômica foi verificada com base no índice de bens, dividido em quintis. Os alimentos mais consumidos diariamente foram: pão branco (83%), manteiga ou margarina (74,6%), feijão (66,4%) e leite (48,5%). O consumo de manteiga ou margarina, pão e feijão foram mais freqüentes entre adolescentes pertencentes ao primeiro (menor) quintil do índice de bens, e o consumo de leite foi maior no último quintil. Frutas, vegetais e salada verde tiveram baixo consumo principalmente entre os mais pobres. Todos os grupos socioeconômicos apresentaram consumo elevado de alimentos ricos em gordura e baixo consumo de alimentos ricos em fibra.

The aim of this study is to describe the methodology of the 2004-2005 follow-up visit of the 1993 Pelotas (Brazil) birth cohort. All children born in Pelotas in 1993 and whose mothers lived in the city at that time were eligible to be enrolled in a longitudinal study. Between July 2004 and March 2005, all cohort participants were sought for a follow-up visit. Several strategies were used to help trace cohort members, including a census of the city's schools and a census of all households in the municipality. The Mortality Information System was monitored in order to identify deaths among cohort members. Of the 5,249 cohort members, 4,452 were interviewed in 2004-5. When added to the 141 deaths, these represent 87.5% of the original cohort. In spite of the logistic and financial difficulties, it is possible to carry out prospective studies with long-term follow-up in the Brazilian context.O objetivo deste artigo é descrever a metodologia do acompanhamento realizado em 2004-2005 da coorte de nascidos em 1993 na cidade de Pelotas, Rio Grande do Sul, Brasil. Todas as crianças nascidas em 1993 nessa cidade, cujas mães residiam no município, foram elegíveis para um estudo longitudinal. Entre os meses de julho de 2004 e março de 2005, todos os participantes da coorte foram procurados para um acompanhamento. Diversas estratégias de busca foram utilizadas para auxiliar na localização dos participantes, sendo as principais um censo em todas as escolas do município e um censo domiciliar. O Sistema de Informações sobre Mortalidade foi monitorado para detecção de óbitos de participantes da coorte. Dos 5.249 participantes da coorte, 4.452 foram entrevistados em 2004-2005, os quais, somados aos 141 óbitos detectados, representam 87,5% da coorte original. Apesar das dificuldades logísticas e financeiras, é possível realizar estudos prospectivos com altas taxas de acompanhamento em longo prazo no contexto brasileiro.

The aim of this study was to describe oral health follow-up studies nested in a birth cohort. A population-based birth cohort was launched in 1993 in Pelotas, Rio Grande do Sul State, Brazil. Two oral health follow-up studies were conducted at six (n = 359) and 12 (n = 339) years of age. A high response rate was observed at 12 years of age; 94.4% of the children examined at six years of age were restudied in 2005. The mean DMF-T index at age 12 was 1.2 (SD = 1.6) for the entire sample, ranging from 0.6 (SD = 1.1) for children that were caries-free at age six, 1.3 (SD = 1.5) for those with 1-3 carious teeth at six years, and 1.8 (SD = 1.8) for those with 4-19 carious teeth at six years (p < 0.01). The number of individuals with severe malocclusions at 12 years was proportional to the number of malocclusions at six years. Oral health problems in early adolescence were more prevalent in individuals with dental problems at six years of age.O objetivo deste trabalho foi descrever estudos de saúde bucal em uma coorte de nascimentos. Em 1993, teve início uma coorte de nascimentos de base populacional em Pelotas, Rio Grande do Sul, Brasil. Dois estudos de saúde bucal aos 6 (n = 359) e 12 anos de idade (n = 339) foram realizados. Foi observada uma alta taxa de resposta no período entre 6 e 12 anos de idade; 94,4% das crianças pesquisadas em 1999 foram examinadas em 2005. A média do índice CPO-D aos 12 anos foi de 1,2 (DP = 1,6) para a população como um todo, variando de 0,6 (DP = 1,1) para o grupo livre de cáries aos 6 anos, 1,3 (DP = 1,5) para os que apresentaram 1-3 dentes atacados pela cárie e 1,8 (DP = 1,8) para aqueles com 4-19 dentes atacados pela cárie (p < 0,01). Observou-se um aumento da proporção de indivíduos com oclusopatias muito severas aos 12 anos, conforme o número de oclusopatias presentes aos 6 anos de idade. Problemas bucais no início da adolescência foram mais prevalentes nos indivíduos que apresentaram agravos à saúde bucal na infância.

Realizou-se revisão sistemática de estudos de reprodutibilidade e validade de instrumentos de medida da atividade física do tipo self-report - medidas subjetivas, em adolescentes (10-19 anos). Buscas foram realizadas em bases de dados (MEDLINE, PsycInfo, SportsDiscus, Scopus, Web of Science, SciELO, Lilacs) e nas referências dos artigos localizados. Sessenta e seis estudos atenderam aos critérios de inclusão. A maioria deles foi realizada em países da América do Norte, apenas cinco no Brasil. Identificaram-se 52 instrumentos diferentes: 42 questionários, 6 diários e 4 entrevistas. A reprodutibilidade "teste-reteste" variou de 0,20 a 0,98; a maioria (28/50) dos coeficientes apresentou valores < 0,70. Os coeficientes de validade apresentaram ampla variação (-0,13 a 0,88), sendo a maioria deles (64/84) < 0,50. Apenas três instrumentos apresentaram correlações > 0,70. Diversos instrumentos foram testados em adolescentes, especialmente questionários. Em geral, tais instrumentos demonstraram melhor reprodutibilidade "teste-reteste" do que validade.This was a systematic review of studies on the reliability and validity of self-report instruments for measuring physical activity, or subjective measurements, in adolescents (10-18 years). Searches were conducted in databases (MEDLINE, PsycInfo, SportsDiscus, Scopus, Web of Science, SciELO, Lilacs) and in the references of the retrieved articles. Sixty-six studies met the inclusion criteria. The majority were from North America, with only 5 from Brazil. Fifty-two different instruments were identified: 42 questionnaires, 6 diaries or logs, and 4 interviews. "Test-retest" reliability varied from 0.20 to 0.98; the majority (28/50) of the coefficients showed values < 0.70. Validity coefficients showed wide variation (-0.13 to 0.88), with the majority (64/84) < 0.50. Only 3 instruments displayed correlations > 0.70. Various instruments were tested in adolescents, especially questionnaires. These instruments generally showed better "test-retest" reliability than validity.

O estudo avaliou a prevalência de internação hospitalar no período de um ano e os fatores associados com base em um censo entre residentes de instituições de longa permanência para idosos em Pelotas, Rio Grande do Sul, Brasil. A internação hospitalar foi avaliada com a pergunta: "Desde do ano passado, o(a) Sr.(a) baixou em algum hospital?". Dos 521 indivíduos elegíveis, coletou-se informação de 466 (89,4%). A prevalência de hospitalização no último ano foi de 23,9% (IC95%: 19,9-27,8) e associou-se com: incapacidade para atividades básicas vida diária, ocorrência de queda no último ano e o fato de ser ex-fumante. Indivíduos solteiros e separados tiveram proteção para internação hospitalar. Houve também associação inversa do desfecho com autopercepção de saúde. A alta prevalência de internação hospitalar encontrada em indivíduos residentes em instituições de longa permanência para idosos é um importante indicador para o planejamento dos serviços de saúde, de forma a bem atender as demandas de uma população em transição demográfica e epidemiológica.The aim of the present study was to evaluate the prevalence of hospital admissions over a one-year period and associated factors through a survey of elderly subjects living in nursing homes in Pelotas, Rio Grande do Sul State, Brazil. Hospital admissions were assessed using the question: "From last year to today, were you admitted to a hospital?" Out of 521 eligible individuals, information was collected for 466 (89.4%). Prevalence of hospital admissions in the previous 12 months was 23.9% (95%CI: 19.9-27.8). Admissions were directly associated with: inability to perform basic activities of daily living, falls, and history of smoking. Single and divorced individuals were less likely to be hospitalized. There was an inverse association between hospitalization and self-rated health. The high prevalence of hospitalization among elderly subjects living in nursing homes is an important indicator for the organization of health services, in order to ensure high-quality services for a population group experiencing a demographic and epidemiological transition.

We aimed to evaluate how Brazilian adults rank seven well-known health-related factors in terms of importance for health. A population-based study was undertaken in Pelotas, Rio Grande do Sul State, Brazil (N = 3,100; response rate: 96.5%). Individuals ranked three out of seven factors that, in their opinion, were the most important for health. The factors investigated were: "controlling stress", "practicing physical activity regularly", "avoiding drinking in excess", "avoiding smoking", "visiting a doctor regularly", "keeping the ideal weight", and "having a healthy diet". Healthy diet (73.9%), physical activity (59.9%), and visiting a doctor regularly (45.7%) were the most frequently reported factors. Younger subjects and those with higher socioeconomic status were more likely to report physical activity and stress as important factors for health than their counterparts. The importance attributed to health-related factors changes markedly among population subgroups.O objetivo foi avaliar como adultos brasileiros ordenam sete fatores relacionados à saúde em termos de importância para a saúde. Estudo de base populacional realizado em Pelotas, Rio Grande do Sul, Brasil (N = 3.100; taxa de resposta: 96,5%). Com base nos fatores listados, os indivíduos ordenaram três que, de acordo com sua opinião, fossem os mais importantes para a saúde. Os fatores investigados foram: "controlar o estresse", "praticar atividade física regularmente", "evitar beber em excesso", "evitar fumar", "consultar um médico regularmente", "manter o peso ideal" e "ter uma dieta saudável". Dieta saudável (73,9%), atividade física (59,9%) e visitar um médico (45,7%) foram os mais citados. Indivíduos jovens e aqueles de melhor nível econômico relataram atividade física e estresse como fatores importantes para a saúde mais freqüentemente que seus pares. A importância atribuída para fatores relacionados à saúde altera-se drasticamente entre subgrupos populacionais.

A transição epidemiológica no Brasil, em parte, é explicada pelos baixos níveis de atividade física da população. Entretanto, poucos estudos têm explorado atividade física em populações de baixa renda. Nesta realidade, as unidades básicas de saúde (UBS) ganham importância. Em estudo com delineamento transversal, avaliou-se a prevalência de sedentarismo e fatores associados em 1.018 adultos e 1.010 idosos, residentes em áreas de UBS de dez municípios com mais de 100 mil habitantes no Estado de Pernambuco, Brasil. A prevalência de sedentarismo foi de 37,18% (IC95%: 34,0-40,2) para adultos e de 68,3% (IC95%: 65,3-71,3) para idosos. A identificação da prática de atividade física como um dos fatores mais importantes para a manutenção da saúde esteve associado com sedentarismo no grupo dos idosos. Foi verificado um menor percentual de sedentarismo entre adultos associado com uma autopercepção de saúde satisfatória. Conclui-se que a prevalência de sedentarismo em áreas de abrangência das UBS em Pernambuco é mais elevada quando comparada com a Região Sul.The epidemiological transition in Brazil has been explained partially by the low levels of physical activity. However, few studies have explored physical inactivity in low-income population groups. Within this context, primary healthcare units gain strategic importance. This article describes the prevalence of sedentary lifestyle and associated factors in a cross-sectional study, including 1,018 adults and 1,010 elderly adults in 10 cities in Pernambuco State. Prevalence of sedentary lifestyle was 37.8% (95%CI: 34.0-40.2) in adults and 68.3% (95%CI: 65.3-71.3) in the elderly. Identification of physical activity as the most important factor for good health was associated with sedentary lifestyle in elderly adults. A lower proportion of sedentary lifestyle among non-elderly adults was associated with good self-reported health status. We concluded that sedentary lifestyle prevalence is high in elderly and non-elderly people covered by primary healthcare units in Pernambuco State as compared to the South of Brazil.

FUNDAMENTO: Medidas válidas da pressão arterial, em situações clínicas e na comunidade, são essenciais para a monitoração dessa variável em nível populacional. OBJETIVO: Avaliar a validade de um monitor digital de pulso para mensuração da pressão arterial em adolescentes, em comparação com um esfigmomanômetro de mercúrio. MÉTODOS: Um estudo de validação foi realizado na cidade de Pelotas, região sul do Brasil. A pressão arterial foi medida duas vezes, utilizando-se dois esfigmomanômetros diferentes: um aparelho digital de pulso OMRON e um aparelho de mesa BD de mercúrio. Metade da amostra foi medida primeiro através do manômetro digital e depois pelo de mercúrio, enquanto a outra metade foi avaliada na ordem inversa. A concordância entre as duas medidas foi avaliada através do método de Bland & Altman. RESULTADOS: 120 adolescentes com idade entre 14 e 15 anos foram incluídos no estudo (50% de cada sexo). A pressão sistólica média entre os meninos foi de 113,7 mmHg (DP 14,2) usando o manômetro de mercúrio e 115,5 mmHg (DP 15,2) usando o aparelho digital. Os valores equivalentes para a pressão diastólica foram 61,5 mmHg (DP 9,9) e 69,6 mmHg (10,2), respectivamente. Entre as meninas, a pressão sistólica média foi de 104,7 mmHg (DP 10,1) usando o manômetro de mercúrio e 102,4 mmHg (DP 11.9) usando o aparelho digital. Os valores equivalentes para a pressão diastólica foram 60,0 mmHg (DP 10,4) e 65,7 mmHg (DP 7,7), respectivamente. CONCLUSÕES: O manômetro digital apresentou alta concordância com o manômetro de mercúrio para medir a pressão arterial sistólica. A concordância foi menor para a pressão arterial diastólica. O uso de equações de correção pode ser uma alternativa para estudos utilizando esse monitor digital de pulso em adolescentes.BACKGROUND: Valid measurements of blood pressure, both at clinical and community settings, are essential for monitoring this variable at the population level. OBJECTIVE: To evaluate the validity of a wrist digital monitor for measuring blood pressure among adolescents in comparison to a mercury sphygmomanometer. METHODS: A validation study was carried out in the city of Pelotas, Southern Brazil. Blood pressure was measured twice using two different sphygmomanometers; an OMRON wrist digital and a desktop BD mercury one. Half of the sample was measured first with the digital manometer and subsequently with the mercury one, whereas the remaining half was evaluated in the opposite order. Agreement between both measures was evaluated using the Bland and Altman method. RESULTS: 120 adolescents aged 14 to 15 years were included (50% of each sex). Mean systolic blood pressure among boys was 113.7 mmHg (SD 14.2) when using the mercury manometer and 115.5 mmHg (SD 15.2) when using the digital one. Equivalent values for diastolic blood pressure were 61.5 mmHg (SD 9.9) and 69.6 mmHg (10.2), respectively. Among girls, the mean systolic blood pressure was 104.7 mmHg (SD 10.1) when using the mercury manometer and 102.4 mmHg (SD 11.9) when using the digital device. Values for diastolic blood pressure were 60.0 mmHg (SD 10.4) and 65.7 mmHg (SD 7.7), respectively. CONCLUSIONS: The digital device showed a high level of agreement with the mercury manometer when measuring systolic blood pressure. The level of agreement was lower for diastolic blood pressure. The use of correction equations may be an alternative for studies using this wrist digital monitor in adolescent patients.

O objetivo foi descrever usuários e não-usuários do Programa Academia da Cidade de Recife, Pernambuco, Brasil. Foram selecionados quatro dos 19 pólos do programa. Para cada usuário sorteado, foi selecionado um não-usuário, que foi pareado ao usuário em termos de sexo, idade (±5 anos) e local de residência. A amostra foi composta por 277 usuários e 277 não-usuários. Entre os não-usuários, 22% referiram nunca ter ouvido falar do programa. Entre os que já ouviram falar do programa, 54,3% o conhecem por terem visto um pólo. Entre os usuários, o principal motivo para a participação no programa foi "melhorar a saúde"; o tempo médio de participação no programa foi de 27,5 meses (DP = 23,1) e 72,8% relataram grau elevado de satisfação. O percentual de pessoas com percepção de saúde regular ou ruim foi significativamente maior entre os não-usuários (45,4%) em comparação aos usuários (28,5%). Os usuários do Programa Academia da Cidade parecem estar satisfeitos. Estratégias de divulgação devem ser priorizadas para que o programa seja conhecido por um maior percentual de residentes de Recife.The aim of this study was to describe the profile of users and non-users of the Academia da Cidade Program to promote physical activity in Recife, Pernambuco State, Brazil. Four of the program's 19 units were sampled. Users (n=277) and non-users (n=277) were matched for gender, age (±5 years), and place of residence. Among non-users, 22% had never heard of the program. Among those who knew of the program, 54.3% learned about it by actually having seen one of the units. Among users, the main reason for participating in the program was to improve their health; mean participation time was 27.5 months (SD = 23.1); and 72.8% reported high satisfaction. The proportion of individuals with fair or poor self-rated health was significantly higher among non-users (45.4%) than users (28.5%). Users of the program appeared to be satisfied. Strategies to further publicize the program should be prioritized to make it known to a larger proportion of the city's population.

O objetivo deste estudo foi analisar a associação entre fatores demográficos, sócio-econômicos, escolares e comportamentais e a prevalência de sobrepeso e obesidade em adolescentes. A amostra foi constituída por 4.210 estudantes (14-19 anos) da rede pública estadual em Pernambuco, Brasil, selecionados mediante amostragem por conglomerados em dois estágios. Além das medidas antropométricas, dados pessoais e comportamentais foram coletadas usando o Global School-Based Health Survey. Pontos de corte utilizados para classificação dos casos de sobrepeso e obesidade foram os propostos pelo International Obesity Task Force. A prevalência de sobrepeso e obesidade foi 11,5% (IC95%: 10,7-12,8) e 2,4% (IC95%: 1,9-2,9), respectivamente. Verificou-se maior risco de sobrepeso e obesidade entre rapazes que residiam em áreas urbanas e que não participavam das aulas de educação física. Entre as moças, assistir à televisão três horas ou mais foi fator associado à ocorrência de obesidade. Redução do tempo de televisão e participação nas aulas de educação física podem ser ações efetivas no enfrentamento da epidemia da obesidade.This study aims to analyze the association between demographic, socioeconomic, school-related, and behavioral factors and overweight and obesity in adolescents. The sample included 4,210 public high school students (14-19 years old) in Pernambuco State, Brazil, selected by two-stage cluster sampling. Obesity and overweight were assessed using anthropometric measurements, and the Global School-Based Health Survey was used to collect personal and behavioral data. The cutoff points for defining overweight and obesity were those recommended by the International Obesity Task Force. Prevalence rates for overweight and obesity were 11.5% (95%CI: 10.7-12.8) and 2.4% (95%CI: 1.9-2.9), respectively. Overweight and obesity were more common in males who reported residing in urban areas and were not enrolled in physical education classes. Watching television 3+ hours/day was associated with obesity in females. Reducing TV time and encouraging enrollment in physical education could be effective measures to counteract the growing obesity trends.

O objetivo deste estudo foi descrever a freqüência de consumo de frutas, legumes e verduras por adultos de 20 a 69 anos de Pelotas, Rio Grande do Sul, Brasil, e analisar fatores associados. Foi realizado em 2006 um estudo transversal de base populacional, incluindo 972 adultos. A freqüência do consumo de frutas, legumes e verduras foi medida por meio de três perguntas referentes ao consumo habitual destes no ano anterior. O desfecho foi o consumo regular de frutas, legumes e verduras. Cerca de 1/5 da população adulta (20,9%) consumia regularmente frutas, legumes e verduras. Indivíduos do sexo feminino, com 60 anos ou mais, das classes A e B, ex-fumantes e não sedentários apresentaram maior prevalência de consumo de frutas e legumes e verduras. A freqüência do consumo de frutas, legumes e verduras na população adulta residente no Município de Pelotas está aquém das recomendações atuais do Ministério da Saúde, em especial entre os homens mais jovens, de menor nível sócio-econômico e que não praticam atividade física no lazer. Políticas públicas que estimulem uma alimentação saudável são urgentemente necessárias.The study aimed to describe the frequency of fruit and vegetable intake among adults (20-69 years of age) and to identify associated factors. This population-based study in 2006 included 972 adults in Pelotas, Southern Brazil. Consumption of fruits and vegetables was evaluated with three questions on habitual food intake during the year prior to the interview. The outcome variable was regular consumption of fruits and vegetables. Only one in five adults (20.9%) reported consuming fruits and vegetables regularly. Female gender, age 60 years or older, higher socioeconomic status, former smoking, and physical activity were associated with the outcome variable. According to the results, fruit and vegetable intake among adults fails to meet current Ministry of Health recommendations, particularly among male, young, poor, and physically inactive adults. Interventions to encourage healthy diet are urgently needed.

Foi realizado um estudo transversal, em 240 unidades básicas de saúde (UBS) dos modelos tradicional de assistência ou vinculadas ao Programa Saúde da Família (PSF), envolvendo 3.347 profissionais de saúde, que responderam ao Questionário Internacional de Atividade Física. A prevalência de sedentarismo (< 150 minutos por semana) foi de 27,5% (IC95%: 25,9-29,0). O sedentarismo foi mais freqüente nos profissionais do modelo tradicional, sendo tal diferença explicada pela presença dos agentes comunitários de saúde, cuja ocupação é bastante ativa apenas no modelo PSF. Houve maior percentual de sedentarismo nos profissionais que trabalham em municípios de grande porte e possuem alto nível sócio-econômico. Destaca-se a importância de projetos de capacitação de profissionais de saúde para a orientação e a prática de atividade física e a articulação entre profissionais de UBS e educadores físicos.This cross-sectional study analyzed 240 primary healthcare units, linked either to the traditional primary care model or the Family Health Program (FHP), involving a total of 3,347 health professionals who answered the International Physical Activity Questionnaire. Prevalence of sedentary lifestyle (< 150 minutes of physical activity per week) was 27.5% (95%CI: 25.9-29.0). Sedentary lifestyle was more frequent among health professionals in the traditional model, with the difference explained by the presence of community health agents, whose work only involves extensive physical activity in the FHP model. Sedentary health professionals were proportionally more common in large cities with better socioeconomic conditions. The study highlights the importance of education for health professionals aimed at orientation and practice in physical activities and collaboration between primary healthcare workers and physical education teachers.

O objetivo deste estudo foi avaliar o conhecimento populacional sobre as associações de quatro fatores comportamentais (sedentarismo, tabagismo, consumo excessivo de álcool e alimentação inadequada) com oito morbidades (diabetes, hipertensão arterial, AIDS, osteoporose, câncer de pulmão, depressão, cirrose hepática e infarto agudo do miocárdio). Foi realizado um estudo transversal de base populacional, incluindo 2.096 indivíduos de dez anos ou mais. O processo de amostragem foi probabilístico por conglomerados. Para cada fator comportamental, foi gerado um escore de conhecimento, que variava de zero a oito pontos. A maior média do escore foi registrada para o conhecimento sobre alimentação inadequada (5,3), seguida por tabagismo (5,1), sedentarismo (4,7) e consumo excessivo de álcool (4,5). Em geral, maiores escores de conhecimento estiveram relacionados com maior escolaridade, nível sócio-econômico e faixas etárias intermediárias. Estratégias governamentais a fim de aumentar o conhecimento populacional sobre fatores de risco para doenças crônicas são necessárias.The aim of the present study was to evaluate public awareness of the association between four behavioral factors (sedentary lifestyle, smoking, alcohol abuse, and inadequate diet) and eight diseases (diabetes, hypertension, AIDS, osteoporosis, lung cancer, depression, liver cirrhosis, and acute myocardial infarction). We conducted a population-based cross-sectional study including 2,096 individuals 10 years or older. A random clustered sampling strategy was used. For each behavioral factor, a knowledge score was constructed, ranging from zero to eight points. The highest mean score was observed for inadequate diet (5.3), followed by smoking (5.1), sedentary lifestyle (4.7), and alcohol abuse (4.5). Overall, higher knowledge scores were observed among people with high socioeconomic status and more schooling, and in intermediate age groups. Government health promotion strategies are needed to raise public awareness of risk factors for chronic diseases.

O objetivo deste estudo foi avaliar o conhecimento dos adultos de Pelotas, Sul do Brasil, sobre o papel da atividade física na prevenção e tratamento de diabetes e hipertensão arterial, e os fatores associados aos conhecimentos. Foi realizado um estudo transversal de base populacional, com amostragem por conglomerados, incluindo 972 indivíduos de 20 a 69 anos. O conhecimento dos efeitos da atividade física na prevenção e tratamento foi maior para a hipertensão (82%) do que para diabetes (47,2%). Para a prevenção de diabetes maiores conhecimentos se associaram ao sexo feminino (RP = 1,16; IC95%: 1,03-1,31), e no tratamento além destes, indivíduos ativos, obesos e de elevado nível econômico, tiveram maior conhecimento. Na prevenção da hipertensão, elevado conhecimento associou-se ao maior nível econômico (RP = 1,23; IC95%: 1,11-1,36). Quanto ao tratamento, mulheres, indivíduos ativos e obesos apresentaram maior conhecimento. Em síntese, o conhecimento sobre o papel da atividade física no tratamento de diabetes e hipertensão é maior, em comparação à prevenção; tal achado merece destaque, pois a capacidade de prevenção da atividade física não parece estar tão bem difundida em termos populacionais.The aim of this study was to evaluate public knowledge on the role of physical activity in the prevention and treatment of diabetes and hypertension, and the factors associated with such knowledge. A population-based cross-sectional study was conducted in Pelotas, southern Brazil, including 972 adults aged 20 to 69 years, selected with a clustering protocol. Knowledge on the preventive and curative benefits of physical activity was higher for hypertension (87.2%) than for diabetes (47.2%). Women were more knowledgeable on the role of physical activity in preventing diabetes (PR: 1.16; 95%CI: 1.03-1.31). In terms of treatment, greater knowledge was associated with female gender, current physical activity, obesity, subjects, and higher socioeconomic status. For prevention of hypertension, greater knowledge was observed in individuals with higher socioeconomic status (PR: 1.23; 95%CI: 1.11-1.36). For treatment of hypertension, physically active and obese subjects showed greater knowledge. Subjects were generally more knowledgeable on the curative role of physical activity than on its preventive benefits. Public health efforts should aim to raise public awareness on the preventive effects of physical activity against diabetes, hypertension, and other chronic non-communicable diseases.

O Programa de Pós-graduação em Epidemiologia da UFPel realizou um intenso trabalho de auto-avaliação para resolver problemas identificados com seu curso de mestrado. O resultado foi a introdução de uma estrutura curricular baseada em dois pilares. De um lado, disciplinas de cunho teórico, fornecendo a base da formação do mestrando; de outro, disciplinas de cunho prático, onde os alunos trabalham coletivamente a construção de seu projeto de pesquisa, passando pela escolha de um tema, revisão da literatura, definição de objetivos e da metodologia. Esse esforço conjunto culmina na realização de um trabalho de campo único, na forma de um estudo transversal de base populacional, em que todos os mestrandos participam de maneira integral, obtendo dados para sua dissertação. Essa estratégia tem garantido a formação de mestres em epidemiologia com forte base teórica e com experiência de preparação e condução de um trabalho de campo. Além disso, tem sido possível manter um tempo de titulação abaixo de 24 meses. Cerca de 80% dos egressos têm publicado pelo menos um artigo baseado em seu mestrado. Destas publicações, quase 90% têm se dado em periódicos classificados como Internacional-A no Qualis da Capes.The postgraduate program in epidemiology of the Federal University of Pelotas, Brazil, went through an intense self-assessment process to solve problems related to its Master's course. The result was the introduction of a curricular structure based on two pillars. The first one: theoretical courses to offer students the bases of epidemiology. The other, practical training in which students work in groups to design their research projects, from the choice of a research question, to literature review, definition of objectives and methods. This joint effort leads to shared fieldwork, a cross-sectional population-based study, where all students have full participation and get data for their dissertations. This strategy has provided students with strong theoretical background and experience in preparing and conducting fieldwork. Besides, a median completion time below 24 months has been achieved. About 80% of the students who complete the course published at least one paper based on their dissertations; and almost 90% of these papers were published in journals classified as A-International by the Qualis criteria established by Capes.

The aim of this study was to evaluate the association between size at birth (birthweight and birth length) and height in early adolescence in a prospective birth cohort study in Pelotas, Rio Grande do Sul, Brazil. Interviews were carried out in 1993, including measurements of birthweight and length, and in 2004-2005, including measurements of weight and height. This analysis includes 4,452 individuals, with a mean age of 11.3 years (standard deviation - SD = 0.3), representing a follow-up rate of 87.5%. Mean height at 11 years was 145.8 cm (SD = 7.9), or 144.9 cm (SD = 7.7) in boys and 146.8 cm (SD = 7.9) in girls. Birthweight and birth length were positively associated with height in early adolescence in the crude analysis, but after adjustment for confounding and for each other, only the effect of birth length was still significant. A one z-score increase in birth length was associated with a 1.63 cm increase in height at 11 years. The present study shows that birth length is a strong predictor of later height, while the effect of birth weight disappears after adjustment for birth length.O objetivo deste estudo foi avaliar a associação entre o tamanho ao nascer (peso e comprimento) e altura no início da adolescência em uma coorte de nascimentos prospectiva em Pelotas, Rio Grande do Sul, Brasil. Entrevistas foram conduzidas em 1993, incluindo mensuração de peso e comprimento ao nascer, e em 2004-2005, incluindo mensuração de peso e altura. Esta análise inclui 4.452 indivíduos com idade média de 11,3 anos (DP = 0,3), representando uma taxa de acompanhamento de 87,5%. A média de altura aos 11 anos foi de 145,8cm (DP = 7,9), sendo 144,9cm (DP = 7,7) entre os meninos e 146,8cm (DP = 7,9) entre as meninas. O peso e o comprimento ao nascer associaram-se positivamente com a altura no início da adolescência na análise bruta, mas após ajuste para fatores de confusão e um para o outro, apenas o efeito do comprimento continuou significativo. Um aumento de um escore-z no comprimento ao nascer esteve associado com um aumento de 1,63cm na altura aos 11 anos. O estudo mostra que o comprimento ao nascer é um forte preditor da altura futura, enquanto o efeito do peso ao nascer desaparece após ajuste para o comprimento ao nascer.

As mudanças na pirâmide demográfica brasileira e conseqüente envelhecimento populacional têm promovido aumento de doenças crônicas. Nesta realidade, as unidades básicas de saúde e a atividade física ganham importância. Em um estudo com delineamento transversal, avaliou-se a prevalência de sedentarismo e fatores associados em 4.060 adultos e 4.003 idosos, residentes em áreas de unidades básicas de saúde de 41 municípios com mais de 100 mil habitantes, em sete estados do Brasil. A prevalência de sedentarismo foi de 31,8% (IC95%: 30,4-33,2) e 58% (IC95%: 56,4-59,5) para adultos e idosos respectivamente, sendo sempre maior na Região Nordeste e nos homens. Baixa renda familiar foi fator de risco para sedentarismo nos adultos e idosos, enquanto a baixa escolaridade apresentou um efeito somente entre os idosos. Houve relação inversa entre autopercepção de saúde e sedentarismo para adultos e idosos. A prevalência média de sedentarismo foi maior na área de abrangência das unidades básicas de saúde Pré-PROESF em comparação aos outros modelos de atenção básica. Conclui-se que a prevalência de sedentarismo é muito elevada e que os grupos sócio-econômicos mais desfavorecidos apresentam nível menor de atividade física.Shifts in Brazil's demographic structure have expanded the country's elderly population and consequently increased the rates of chronic diseases. This paper describes the prevalence of sedentary lifestyle and associated factors in a cross-sectional study, including 4,060 non-elderly and 4,003 elderly adults in 41 cities in seven States of the country. Prevalence of sedentary lifestyle was 31.8% (95%CI: 30.4-33.2) in non-elderly adults and 58.0% (95%CI: 56.4-59.5) in the elderly; sedentary lifestyle was more frequent in the Northeast and among males. Low family income was associated with higher prevalence of sedentary lifestyle in both non-elderly and elderly adults, while low schooling was only observed among the elderly. There was an inverse association between self-reported health status and sedentary lifestyle. Mean prevalence of sedentary lifestyle was higher in areas covered by pre-PROESF units in comparison to other health system models. We conclude that sedentary lifestyle is highly prevalent and that disadvantaged socioeconomic groups are more likely to be sedentary.

Birth weight has short and long-term effects on health. Some studies have used retrospective data on birth weight, reported by the subject or by the parents. This paper compares data on birth weight measured by the research team in 1993 with birth weight reported by the mother in 2004-2005, using data from the 1993 Pelotas Birth Cohort Study, Rio Grande do Sul State, Brazil. We also evaluate the role of misclassification when exploring the effect of birth weight on a given outcome. Mean difference between the two variables was 20g (SD = 288.3). Agreement for detecting low birth weight was 95.2% in the sample as a whole (kappa = 0.73), but was lower among low-schooling mothers. Mothers of children weighing less than 3,500g at birth tended to overestimate the child's birth weight. Inversely, mothers of heavier children tended to underestimate the values. One out of four mothers reported a difference of at least 200g in birth weight as compared to that measured in 1993. Use of reported birth weight diluted the magnitude of the association with body mass index at 11 years in comparison with measured birth weight. Reported birth weight should be used with great caution, if at all.O peso ao nascer exerce efeitos em curto e longo prazo sobre a saúde. Alguns estudos usam dados retrospectivos sobre o peso ao nascer, relatado pelo indivíduo ou pelos pais. Neste artigo nós comparamos o peso ao nascer medido em 1993 pela equipe de pesquisa com o relatado pela mãe em 2004-2005, usando-se dados da Coorte de Nascimentos de 1993 em Pelotas, Rio Grande do Sul, Brasil. Também avaliamos o papel do erro de classificação quando se explora a associação entre peso ao nascer e um determinado desfecho. A diferença média entre as duas variáveis foi de 20g (DP = 288,3). O percentual de concordância para a detecção de baixo peso ao nascer foi de 95,2% na amostra total (kappa = 0,73), mas foi menor entre as mães com baixa escolaridade. As mães de crianças que nasceram com menos de 3.500g tenderam a superestimar o peso ao nascer de seus filhos, enquanto as mães de crianças que nasceram com mais de 3.500g tenderam a subestimar o peso ao nascer de seus filhos. Uma em cada quatro mães relatou um peso ao nascer mais de 200g diferente do que foi medido em 1993. O uso do peso ao nascer relatado diluiu a associação com índice de massa corporal aos 11 anos de idade quando comparado ao peso ao nascer mensurado. O peso ao nascer relatado deve ser usado (se for usado) com muita cautela nessa população.

In a prospective birth cohort study in Brazil, the prevalence and early risk factors for smoking in adolescence were investigated. All 1982 hospital-born children in Pelotas, Rio Grande do Sul, Brazil, were enrolled in a birth cohort study (N = 5,914; boys: 3,037; girls: 2,877). All male participants were searched in 2000 when enrolling in the national army, and 78.8% were traced. In 2001, a systematic sample of 473 girls was interviewed, representing a follow-up rate of 69.1%. Among males, 48.6% (95%CI: 46.6-50.7) had ever tried smoking and 15.8% (95%CI: 14.3-17.3) were daily smokers. Among females, 53.1% (95%CI: 48.6-57.6) had ever tried smoking and 15.4% (95%CI: 12.1-18.7) were daily smokers. Boys born to single mothers and those with fathers with low schooling were more likely to smoke in adolescence. Girls from low-income families, with mothers who smoked during pregnancy, and fathers with alcohol-related problems were more likely to smoke. Although the smoking prevalence was similar in boys and girls, risk factors for smoking were different between the sexes. Social environment appears to be the strongest predictor of tobacco use in adolescence.A prevalência e os determinantes precoces do fumo na adolescência foram investigados em uma coorte pros-pectiva de nascimento no Brasil. Todos os nascidos vivos em hospitais de Pelotas, no Sul do Brasil, em 1982 foram incluídos em um estudo de coorte de nascimentos (N = 5.914; meninos: 3.037; meninas: 2.877). Todos os participantes do sexo masculino foram procurados em 2000 durante o alistamento militar, e 78,8% foram localizados. Em 2001, uma amostra sistemática de 473 meninas foi entrevistada, representando uma taxa de acompanhamento de 69,1%. Entre os homens, 48,6% (IC95%: 46,6-50,7) já haviam experimentado cigarro e 15,8% (IC95%: 14,3-17,3) eram fumantes diários. Entre as meninas, 53,1% (IC95%: 48,6-57,6) já haviam experimentado cigarro e 15,4% (IC95%: 12,1-18,7) eram fumantes diárias. Meninos filhos de mães solteiras e de pais com baixa escolaridade tiveram maior probabilidade de fumar na adolescência. Meninas pertencentes a famílias de baixa renda, com mães que fumaram durante a gravidez e pais com problemas relacionados ao álcool apresentaram maior probabilidade de fumar. Embora a prevalência de fumo tenha sido similar entre meninos e meninas, os fatores associados ao fumo variaram entre os sexos. O ambiente social parece ser o preditor mais forte do uso de tabaco na adolescência.

This study evaluated knowledge and use of generic drugs in a population-based sample of adults from a southern Brazilian city. The outcomes were: the proportion of generics in total medicines used; theoretical and practical knowledge about generics; and strategies used to buy medicines on medical prescriptions. The recall period for drug utilization was 15 days. The proportion of generics in total medicines was 3.9%. While 86.0% knew that generics cost less and 70.0% that the quality is similar to brand name medicines, only 57.0% knew any packaging characteristics that distinguish generics from other medicines. The highest proportion of generic drug utilization was in the antimicrobial pharmacological group. A brand name medicine (with a brand similar to the generic name) was mistakenly classified as a generic through photos by 48.0% of the interviewees. Among subjects who bought medicines in the 15-day period, 18.9% reported buying a generic, but this result should be interpreted with caution, because the population frequently fails to differentiate between generics and other medicines.Este estudo avaliou o conhecimento e utilização de medicamentos genéricos em uma amostra populacional de adultos de uma cidade no sul do Brasil. Os desfechos foram: proporção de genéricos sobre o total de medicamentos usados; conhecimento teórico e prático sobre medicamentos genéricos; estratégias usadas para compra de medicamentos com prescrição médica. O período recordatório para uso de medicamentos foi de 15 dias. A proporção de genéricos no total de medicamentos foi de 3,9%. Enquanto 86,0% sabiam que o preço dos genéricos era menor e 70,0% que a qualidade era equivalente aos medicamentos de marca, apenas 57,0% conheciam alguma característica da embalagem que diferencia os genéricos de outros medicamentos. A maior proporção de uso de genéricos foi encontrada no grupo farmacológico dos antimicrobianos. Um medicamento de marca (com nome comercial semelhante ao genérico) foi erroneamente classificado como genérico através de fotos por 48,0% das pessoas. Entre os indivíduos que compraram medicamentos no período de 15 dias, 18,9% relataram comprar um genérico, mas esse resultado deve ser interpretado com cautela, pois freqüentemente a população não consegue diferenciar os genéricos dos demais medicamentos.

OBJETIVO: Descrever os hábitos miccionais e suas disfunções em uma amostra populacional de crianças de 3 a 9 anos. MÉTODOS: Delineamento transversal, incluindo 580 crianças. Uma amostra probabilística de domicílios da zona urbana da cidade de Pelotas (RS) foi selecionada em múltiplos estágios. Os hábitos miccionais e fecais foram avaliados com o escore de disfunção miccional proposto por Farhat et al. e modificado pela equipe de pesquisa com acréscimo do sintoma freqüência urinária superior a oito vezes ao dia. Os meninos com pontuação maior que oito e as meninas com pontuação maior que cinco foram reavaliados clinicamente, assim como uma subamostra dos demais. RESULTADOS: Os sintomas miccionais mais freqüentes foram noctúria (60,4%), urgência miccional (49,7%) e manobras de contenção (42,1%). A prevalência de enurese foi de 20,1% em meninos e 15,1% em meninas. A prevalência de disfunção miccional pelo escore Farhat et al. foi de 24,2%. A maioria dos sintomas foi mais freqüente entre as meninas e entre crianças mais jovens. As meninas de nível econômico baixo apresentaram maior freqüência de enurese e força para urinar, enquanto que, entre os meninos, a urgência miccional foi mais comum entre os mais pobres. Apenas 10,5% dos pais de crianças com disfunção haviam levado seu filho ao médico por causa dos sintomas. CONCLUSÕES: Os sintomas miccionais apresentam prevalências altas e devem ser investigados ativamente nas consultas de rotina, com perguntas diretas sobre cada sintoma isoladamente, objetivando o diagnóstico de disfunção miccional.OBJECTIVE: To describe voiding patterns and related dysfunctions in a population-based sample of children aged 3 to 9 years. METHODS: A cross-sectional population-based survey including 580 children. A probabilistic sample of households in the urban area of Pelotas in southern Brazil was selected following a multiple-stage protocol. Voiding and fecal patterns were investigated using the dysfunction score created by Farhat et al. and modified by the addition of high urinary frequency (more than eight times a day). Boys with scores above eight and girls above five were clinically investigated, as well as a sub-sample of the remaining children. RESULTS: Nocturia (60.4%), urinary urgency (49.7%) and holding maneuvers (42.1%) were the most frequently reported symptoms. The prevalence of enuresis was 20.1% in boys and 15.1% in girls. The prevalence of urinary dysfunction was 22.8%. Most symptoms were more frequently reported by girls and younger children. Among girls, low socioeconomic level was related to an increased prevalence of enuresis and straining to urinate, while among boys urgency was more common among the poor. Only 10.5% of the parents of the children with voiding dysfunction consulted a doctor because of their problems. CONCLUSIONS: The voiding symptoms studied presented high prevalence rates, and therefore should be investigated in clinical practice, with direct questions about each symptom, aiming to diagnose voiding dysfunction.